Evaluation of Responsiveness of Community Health Services in Urban China: A Quantitative Study in Wuhan City

Luo, Qianqian; Wang, Qi; Lu, Zuxun; Liu, Junan

doi:10.1371/journal.pone.0062923

Cited by 23 publications

(17 citation statements)

References 12 publications

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“…Responsiveness being the ability to respond to the legitimate expectations of potential users about nonhealth enhancing aspects of care, in this study we found that, of the seven domains which were measured, confidentiality and clear communication had high mean scores; with regard to confidentiality this might have been due to the ongoing primary health care development program since 2007 where the primary health care facilities are the main target for infrastructural improvement, this program has been coupled with provision of training, workshops and offering of Standard Operating Procedures (SOP) on confidentiality and effective communication at the primary health facilities levels, the findings of this study is in line with other studies which were conducted in Ethiopia and Iran [27,28]. While contrarily to another study done in China whereby dignity and confidentiality were ranked highest while choice and prompt attention lowest [29].…”

Section: Discussionsupporting

confidence: 85%

Assessing health system responsiveness in primary health care facilities in Tanzania

Kapologwe

Kibusi

Borghi

et al. 2020

BMC Health Serv Res

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Background: Health system performance is one of the important components of the health care delivery; its achievement depends on the quality of services rendered and the health system responsiveness of its beneficiaries. Health system responsiveness is a multi-dimensional concept and is usually measured through several domains. Health system responsiveness (HSR) remains to be a key indicator for evaluation of health system performance in any settings. This study aimed at assessing the situation of health system responsiveness in primary health facilities in Tanzania prior to introduction of the Direct Health Facility Financing (DHFF) program. Methods: This was a cross sectional study conducted between January and February in 2018. We collected data from 42 primary health facilities (14 health centers and 28 dispensaries) where a questionnaire was administered to a total of 422 participants. The questionnaire collected information on attention, respect to dignity, clear communication, autonomy, access to care, respect to confidentiality and basic amenities. Descriptive analysis was done to determine the distribution of the variables whereas ANOVA and linear regression analysis was employed to discern the association between variables. Results: More than 67% of participants had visited the same health facility more than 5 times. Sixty seven percent of the patients were residing within 5kms from the public primary health care facilities. The geographical access to health care scored the lowest (43.5% for Dispensaries and 36% for Health center) mean as compared to other domains of health system responsiveness. The highest score was in respect to confidentiality (86.7%) followed by respect to dignity (81.4%). Linear regression analysis revealed no statistical association between any of the social demographic features with the overall HSR performances. However, in post hoc analysis, Pwani and Shinyanga regions didn't differ significantly in terms of their performances whereas those two regions differ from all other regions. Conclusion: Based on the study findings health system responsiveness domains has performed relatively poor in many regions except for respect of dignity and confidentiality scored high of all the domains. Shinyanga and Pwani regions scored relatively well in all domains this could have been due to the effect of Results Based financing (RBF) in the respective regions. All in all the Government and other stakeholders in the health sector they should deliberately invest on the access to care domain as seem to be a challenge as compared to others.

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Section: Discussionsupporting

confidence: 85%

Assessing health system responsiveness in primary health care facilities in Tanzania

Kapologwe

Kibusi

Borghi

et al. 2020

BMC Health Serv Res

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“…We also found that some sociodemographic characteristics, such as economic income, social class, and employment situations of people with mental disorders, could determine their experience with primary care. Autonomy was the most poorly assessed domain, as happened in other studies [23][24][25].…”

Section: Discussionsupporting

confidence: 55%

Mental Health Patients’ Expectations about the Non-Medical Care They Receive in Primary Care: A Cross-Sectional Descriptive Study

et al. 2020

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A health system’s responsiveness is the result of patient expectations for the non-medical care they receive. The objective of this study was to assess mental patients’ responsiveness to the health system in primary care, as related to the domains of dignity, autonomy, confidentiality, and communication. Data were collected from 215 people over the age of 18 with mental disorders, using the Multi-Country Survey Study (MCSS) developed by the World Health Organization. Of them, 95% reported a good experience regarding the dignity, confidentiality, communication, and autonomy domains. Regarding responsiveness, patients valued the dignity domain as the most important one (25.1%). Among the patients who experienced poor confidentiality, five out of seven earned less than 900 euros per month (Χ2 = 10.8, p = 0.004). Among those who experienced good autonomy, 85 out of 156 belonged to the working social class (90.4%), and among those who valued it as poor (16.1%), the highest proportion was for middle class people (Χ2 = 13.1, p = 0.028). The two students and 87.5% of retirees experienced this dimension as good, and most patients who valued it as poor were unemployed (43.5%) (Χ2 = 13.0, p = 0.011). Patients with a household income higher than 900 euros more frequently valued responsiveness as good, regarding those domains related to communication, with OR = 3.84, 95% CI = 1.05–14.09, and confidentiality, with OR = 10.48, 95% CI = 1.94–56.59. To conclude, as regards responsiveness in primary care, the dignity domain always obtained the best scores by people with mental disorders. Low economic income is related to a poor assessment of confidentiality. Working class patients, students, and retirees value autonomy as good.

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“…Some scholars have also suggested ranking the elements, in the contexts of either particular services such as facility-based births 46 or health facility types such as community health centres. 47 …”

Section: Resultsmentioning

confidence: 99%

What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework

2017

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Responsiveness is a key objective of national health systems. Responsive health systems anticipate and adapt to existing and future health needs, thus contributing to better health outcomes. Of all the health systems objectives, responsiveness is the least studied, which perhaps reflects lack of comprehensive frameworks that go beyond the normative characteristics of responsive services. This paper contributes to a growing, yet limited, knowledge on this topic. Herewith, we review the current frameworks for understanding health systems responsiveness and drawing on these, as well as key frameworks from the wider public services literature, propose a comprehensive conceptual framework for health systems responsiveness. This paper should be of interest to different stakeholders who are engaged in analysing and improving health systems responsiveness. Our review shows that existing knowledge on health systems responsiveness can be extended along the three areas. First, responsiveness entails an actual experience of people’s interaction with their health system, which confirms or disconfirms their initial expectations of the system. Second, the experience of interaction is shaped by both the people and the health systems sides of this interaction. Third, different influences shape people’s interaction with their health system, ultimately affecting their resultant experiences. Therefore, recognition of both people and health systems sides of interaction and their key determinants would enhance the conceptualisations of responsiveness. Our proposed framework builds on, and advances, the core frameworks in the health systems literature. It positions the experience of interaction between people and health system as the centrepiece and recognises the determinants of responsiveness experience both from the health systems (eg, actors, processes) and the people (eg, initial expectations) sides. While we hope to trigger further thinking on the conceptualisation of health system responsiveness, the proposed framework can guide assessments of, and interventions to strengthen, health systems responsiveness.

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Evaluation of Responsiveness of Community Health Services in Urban China: A Quantitative Study in Wuhan City

Cited by 23 publications

References 12 publications

Assessing health system responsiveness in primary health care facilities in Tanzania

Assessing health system responsiveness in primary health care facilities in Tanzania

Mental Health Patients’ Expectations about the Non-Medical Care They Receive in Primary Care: A Cross-Sectional Descriptive Study

What is health systems responsiveness? Review of existing knowledge and proposed conceptual framework

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